Richard Titmus wrote in his concept of social policy about what he called the 'stranger'. He said the ultimate in social policy is to give to the stranger because you recognise that she or he is the same as you. You don't give to the stranger because they are hungry or because they are tired but because you recognise the problems of hunger and tiredness. In other words you see them as part of yourself and part of what you are responsible for. If you see them as 'the Other, you don't get that sense of responsibility.
John Rawls, who talks about justice, also uses a similar sort of model by saying that if you punish other people you always have to work on the basis that it might happen to you, which is another formulation in a slightly different format.
It is a fact in the USA that 64 million people do not have health insurance, which means there is a third world country within a country that boasts to the world that it is apparently the best.
Of course, I want everyone to have some form of health care, in this country. I think everyone would like to see that. Here, everyone gets treated, regardless of ability to pay. No one is turned out. 3 things, though, bother me about government healthcare. I know a few people personally, that complain bitterly about being unable to afford healthcare, and I can understand their point. I mean after the card payments for the new plasma tv, an upgraded computer, home entertainment center, and multiple car payments, who has money for healthcare? Government should pay for it, right? Now I am sure this doesn't apply to everyone. I know my Dad would not be living today, under government healthcare. With his multiple strokes in his 70s, he would be considered too old to be properly treated, as a young person would be treated. It would be considered a waste of money...taxpayer money, that is. Such is healthcare abroad, that everyone admires. Lastly, I would be very hesitant to have politicians decide my healthcare...who I see, when I see them, and what treatment I should receive. Already you can see the various "police" out now, searching for the wrongdoers...example: Food Police. I can see manditory exercise and weight control. Food checks. Alcohol, tobacco? Forget it. Pregnant? Better follow government guidelines carefully, or be denied full pediatric coverage. This is not fanciful dreaming. Special interest groups will have a field day. Government healthcare? No thanks. Based on your history of controlling things, I'll pass. I'd rather pay for it out of my pocket someway...even give up that new cellphone with all the trimmings. Lord knows, I'd hate to be a nurse in Canada or Europe.
I have no idea about Europe - but we are now moving away from rationing of healthcare - everyone gets regardless of if they're old or not. Its not a perfect system and it has flaws - but we at least are looking at prevention.
I would rather have government make health-care decisions than for-profit corporations, any day.
At least the corporation is moderately accountable. If they do not do well, it makes the press, profits go down. Not so for a federal bureacracy. They can behave in any way they wish, and thumb their noses at the press. Don't believe me? Check out the care in most VA hospitals, where the motto is "We Don't Care Because We Don't Have To." Check out the IRS, or any other massive federal bureaucracy.
also ask how many who do not have health insurance what they have preferred to spend their dollars on
Big TV
Big Cars
Big houses
ETC
Some do not have insurance yes, because they cannot afford it, but others chose NOT to have it, knowing that YES, the care will be given and they can then ask for charity care
But governments do have to get reelected Kevin. The one real live wire in Canadian politics is healthcare. Any party seen as being an enemy of healthcare can kiss their election day dreams goodbye.
Quote from Dazzle 256 "Most of the time our ER looks like a Drs office...runny noses....tummy aches they've had for 3 mos. We do have clinics that do take care of the people without insurance but guess its not convenient to go to."
People with insurance go to the doctor when they have these problems, not to the ER. How can you say this doesn't effect nursing?! Those working in the ER are getting bogged down with these patients, when they should be dealing with emergencies only. It also costs the hosptial money, they don't just get treated for free, the hospital eats it.
As for free clinics, some of these people don't know about them, others do. For those that do know and use the ER instead, do you know what it is like at a free clinic? They may wait for hours before being seen. They are made to feel like thier time isn't as valuable as someone who has insurance. I'm not talking about people who just don't want to work. I'm talking about people who are employed and are working like crazy just to pay their bills. They get sick and put off a doctors visit because they can't afford to take the time off from work to sit for hours waiting to be seen in the free clinic. As a result, when they do seek treatment, they are sicker and harder to treat. (Read: more expensive/bigger drain on the system.)
How can anyone say this doesn't effect nursing. If you can honestly say that you aren't looking at the larger picture.
also ask how many who do not have health insurance what they have preferred to spend their dollars on
Big TV
Big Cars
Big houses
ETC
Some do not have insurance yes, because they cannot afford it, but others chose NOT to have it, knowing that YES, the care will be given and they can then ask for charity care
Its all very well to dismiss the have nots in such a steriotyping way - but baloney....big? BIG? most of those who do not have are the little insignificant people that society runs over..........
At least in the UK our service includes everyone and is social. It may have its ups and downs but it is inclusive. It also doesn't discriminate, which brings it round to my original comment about poor America - America the greatest nation in the world - the market leader and the very big paradox about health care.
You have stated that in actual fact everyone can get medicine from the ER without insurance but much later on in the diease progress.....thus proving in part that the care process is limited.
I wonder if the mortality figures affect this breech?
Despite the very weak state of the dollar at the moment - all the world watch Hollywood and consider that you are the richest, most affluent nation.....so why doesn't your nation invest in basic care for your people?
Right. Big car, big TV. How about those of us struggling to make it? With a car with 240,000 miles on it that I only drive to work because I can't afford to live in the city, so must commute from the small town in which I reside. I can barely afford the basics. Food, shelter, medical bills, Rx. I've cut down by not eating as healthy (since fresh food costs so much more), giving my pets away to my parents, and choosing which Rx I can do away with. And no, my T.V. is not large, or hooked up to cable, it was free from my parents. (yep, I'm lucky to be in the good ol' USofA and have a TV, I know) No, my dwelling is not large, and no I don't drive a big or fancy car. How about that? And I'm pretty well off to tell you the truth. I'm not on welfare, I don't need food stamps, and I have a job, thank God. What about those who don't? I usually have about $100 left over after bills, and I make too much to qualify for Medicaid. How about me and the hundreds or thousands like me? I guess we should just get care from the ER for the life-threatening stuff, and mental health or chronic health be damned. I guess since my neighbor and fellow country-men/women can afford a big house, car, TV, cell phone, I should just suck it up. Right?
Well, all I can say now that everything has been said over and over again, there are flights leaving everyday for the UK, and according to Larry, it is perfect, will solve all your problems.
Such a compassionate reply to someone who's obviously making it but struggling.
A typical response...you don't like it, there's the door. Instead of looking for answers to solve the problem, lets just shove it under the rug, out of our sight, so we're not bothered by it or have to deal with it.
Boy, I'm in a fiesty mood today.
It's never good enough kukitty. Some would have you sell your tv and your old car. THOSE are luxuries. They would probably insist yuou eat better too, because you know you're responsible for your own health and eating junk will make you sick.
No, no. We don't treat AIDs cases. We just tell them they are on their own and let them fend for themselves. Of course we treat AIDs patients! Regardless of ability to pay.
Make no mistake, we do not treat "some" people without health insurance. We treat everyone who walks in the door. The law requires it. And guess what? I trained in the management of chronic diseases, as well. I also have training that is not available in the UK, as I am a nurse anesthetist. I don't assist the anesthesiologist, I administer anesthesia myself. In truth, I have to be pretty well versed in the management of most chronic diseases in order to do this.
We are not cretins. We don't turn people away. We even have health clinics that provide preventative care for patients at low or no cost. The problem is that in most areas, the poorer populations do not avail themselves of programs until they become sick. (Not that they are less intelligent, but preventative health care is not a priority to them.) I can't imagine that having the government take over our health care system will improve that.
Kevin McHugh
Awesome post.
Larry, an outsider's perspective is just that, an outsiders. ALL people in the US, regardless of ability to pay and even regardless of citizenship status, receive care. And someone's point about them getting "better" care can be partially true in some cases. My Dad who's insured can't always get a CT scan, however, an uninsured will. Why? Because hospitals build into their budgets what is called "charity care" monies that are set aside to pay for the costs of those who can't. So, we as a society pay for it anyway.
There are also several free clinics, homeless clinics, nurse-run clinics, free mammograms on the "mammogram van" that serves ONLY the inner-city, not to mention the Public Health Department that is available.
The problem is not available care, but rather access. Kevin is right, primary care and preventative medicine is not top priority for the poor. Or even the rich.
Hellllllo Nurse, BSN, RN
2 Articles; 3,563 Posts
I would rather have government make health-care decisions than for-profit corporations, any day.